Intradural Epidermoid Cysts of the Cerebellopontine Angle: Diagnosis and Surgery

Vinchon, Matthieu; Pertuzon, B.; Lejeune, Jean‐Paul; Assaker, R.; Pruvo, Jean‐Pierre; Christiaens, J. L.

doi:10.1227/00006123-199501000-00006

Cited by 57 publications

(49 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The variable rate of recurrence reported in the literature is attributed to a short follow-up period. 32,45,55 As Tables 5-7 show, recurrence rates were lower in Group 3 (a higher rate of total removal) for comparable follow-up periods in the other groups.…”

Section: Neuroimagingmentioning

confidence: 84%

“…9,51 Deterred by the risk involved in dissecting the capsule, other authors have opted for a decompressive procedure by evacuating the contents 7,38,44 or have not even attempted to handle the capsule. 55 With a capsule remnant, recurrence is inevitable with time, and the capsule cannot be totally removed in recurrent cases. The use of microsurgical techniques, skull base approaches, intraoperative neurophysiological monitoring, neuronavigation, and endoscope-assisted dissection facilitates complete removal of these lesions in many cases.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Giant intracranial epidermoids: is total removal feasible?

Aboud¹,

Abolfotoh

Pravdenkova³

et al. 2015

JNS

View full text Add to dashboard Cite

OBJECT Epidermoid tumors arise from misplaced squamous epithelium and enlarge through the accumulation of desquamated cell debris. Optimal treatment consists of total removal of the capsule; therefore, giant and multicompartmental tumors are particularly challenging. A conservative attitude in handling the tumor capsule is common given concerns about capsule adherence to neurovascular structures, and thus the possibility of recurrence is accepted with the intent of minimizing complications. This study focuses on the outcome of surgery in patients with giant epidermoid tumors for which total capsule removal was the aim. METHODS The authors conducted a retrospective analysis of all patients with giant epidermoid tumors treated by the senior author (O.A.), who pursued total removal of the capsule through skull base approaches. Patients were divided into 2 groups: one including patients with de novo tumors and the other consisting of patients who presented with recurrent tumors. RESULTS Thirty-four patients had undergone 46 operations, and the senior author performed 38 of these operations in the study period. The average tumor dimensions were 55 × 36 mm, and 25 tumors had multicompartmental extensions. Total removal of the tumor and capsule was achieved with the aid of the microscope in 73% of the 26 de novo cases but in only 17% of the 12 recurrent tumor cases. The average follow-up among all patients was 111 months (range 10–480 months), and the average postsurgical follow-up was 56.8 months (range 6–137 months). There were 4 recurrences in the de novo group, and every case had had a small piece of tumor capsule left behind. One patient died after delayed rupture of a pseudoaneurysm. In the de novo group, the average preoperative Karnofsky Performance Scale (KPS) score was 71.42%, which improved to 87.14% on long-term follow-up. In the group with recurrences, the KPS score also improved on long-term follow-up, from 64.54% to 84.54%. In the de novo group, 3 cases (11.5%) had permanent cranial nerve deficits, and 4 cases (15.4%) had a CSF leak. In the recurrence group, 3 cases (25%) had new, permanent cranial nerve deficits, and 1 (8.3%) had a CSF leak. Two patients in this group developed hydrocephalus and required a shunt. CONCLUSIONS Total removal of the capsule of giant epidermoid tumors was achieved in 73% of patients with de novo tumors and was associated with improved function, low morbidity and mortality, and a lower risk of recurrence. Surgery in patients with recurrent tumors was associated with higher morbidity and persistence of the disease.

show abstract

Section: Neuroimagingmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Giant intracranial epidermoids: is total removal feasible?

Aboud¹,

Abolfotoh

Pravdenkova³

et al. 2015

JNS

View full text Add to dashboard Cite

show abstract

“…21) EC frequently occurs in the cerebellopontine angle 26) and fourth ventricle, 16) usually between the ages of 20 and 40 years. 28) EC accounts for approximately 1% of all intracranial tumors.…”

Section: Introductionmentioning

confidence: 99%

Brainstem Epidermoid Cyst in a Child-Case Report-

Takahashi

Paredes

Scavarda

et al. 2007

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

A 10-year-old girl presented with a brainstem epidermoid cyst manifesting as dysphagia and postprandial vomiting. Magnetic resonance imaging disclosed a cystic mass in the brainstem with associated hydrocephalus. She was treated under a presumptive diagnosis of abscess until the definitive histological diagnosis was established at the fourth admission. In spite of four interventions, she remained in good condition with minimal cranial nerve pareses. Subtotal removal of the epidermoid cyst in the brainstem results in recurrence within a relatively short period, especially in children. Total resection of the tumor is the optimum treatment. The differential diagnosis includes abscess, cystic glioma, and neurenteric cyst.

show abstract

“…16) Therefore, the CT diagnosis of intracranial epidermoid tumors is often difficult because of indistinct margins, close proximity to the skull base, and density similar to that of cerebrospinal fluid. 14) MR imaging shows epidermoid cyst as hypointense on T 1 -weighted imaging without contrast enhancement, and hyperintense on T 2 -weighted imaging.…”

Section: Discussionmentioning

confidence: 99%

Dumbbell-Shaped Intradiploic Epidermoid Cyst Involving the Dura Mater and Cerebellum -Case Report-

Ichimura

Hayashi

Yazaki

et al. 2008

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

A 55-year-old woman presented with an epidermoid cyst extending to the cerebellum manifesting as headaches and pain in the left eye. Magnetic resonance imaging showed an intradiploic part with ring enhancement and an intracerebellar part. Intraoperative inspection revealed erosion of the occipital bone and defective dura mater. The tumor was located both epidurally and subdurally and the cyst consisted of pearly white keratin. The tumor was totally removed and the patient was discharged with no neurological deficit. The intradiploic part of the tumor formed the body and the intracerebellar part was caused by inflammatory reaction, which resulted in the atypical enhancement of the intradiploic part.

show abstract

Intradural Epidermoid Cysts of the Cerebellopontine Angle: Diagnosis and Surgery

Cited by 57 publications

References 24 publications

Giant intracranial epidermoids: is total removal feasible?

Giant intracranial epidermoids: is total removal feasible?

Brainstem Epidermoid Cyst in a Child-Case Report-

Dumbbell-Shaped Intradiploic Epidermoid Cyst Involving the Dura Mater and Cerebellum -Case Report-

Contact Info

Product

Resources

About